Organization
PALM HARBOR DERMATOLOGY PA
Active
Organization
PALM HARBOR DERMATOLOGY PA
Active
Other names
PHDermatology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMY SIMON ROSS MD (CEO)
(813) 333-1512
Entity
Organization
Contact information
Practice address
4197 WOODLANDS PKWY, PALM HARBOR, FL 34685-3493
(727) 786-3810
(727) 786-3855
Mailing address
4197 WOODLANDS PKWY, PALM HARBOR, FL 34685-3493
(813) 333-1512
(813) 333-1561
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ZD0900X
Dermatopathology (Pathology) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000WR
FLORIDA BLUE
FL
Enumeration date
03/25/2008
Last updated
02/28/2025
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